Provider Demographics
NPI:1336401215
Name:CHERRY, SANDRA (LPC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:CHERRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:BURGAW
Mailing Address - State:NC
Mailing Address - Zip Code:28425-5410
Mailing Address - Country:US
Mailing Address - Phone:910-259-0145
Mailing Address - Fax:910-259-0148
Practice Address - Street 1:400 N WRIGHT ST
Practice Address - Street 2:
Practice Address - City:BURGAW
Practice Address - State:NC
Practice Address - Zip Code:28425-5410
Practice Address - Country:US
Practice Address - Phone:910-259-0145
Practice Address - Fax:910-259-0148
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3520101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional